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Emergency changes scheduled to inpatient paediatric services from September 7

Paediatric inpatient services at Alexandra Hospital are due to move to Worcestershire Royal Hospital under emergency measures being taken by the trust. The emergency changes will mean that for the vast majority of children there will be no change to where they receive their care.

Only those children who have a life threatening condition, need to stay overnight in hospital or need to see a specialist paediatrician, will see their care from September delivered at the Worcestershire Royal Hospital.

“This is not a decision we have taken lightly and we recognise that this will for some be a cause of concern. Safety is our top priority and I would like to reassure the public that we are making these temporary changes so that we can ensure the highest levels of care for children.

“Our consultants over many months have continued to work additional shifts to cover vacant junior doctor rotas to keep the paediatric inpatient service going on both sites. This is no longer sustainable. The national shortage of doctors coming through training for paediatric posts, means that many trusts have vacant junior doctor posts.

"In addition, despite an active recruitment campaign, we have been unable to attract doctors to fill the vacant posts left as a result of the junior doctor shortage. This presents a significant issue for the trust in providing specialist paediatric doctor inpatient 24/7 cover on two sites. This has now reached a critical point and the Trust regrettably has to take the difficult decision to temporarily move to centralise inpatient paediatric beds on to one site at Worcestershire Royal Hospital.”

From September Alexandra Hospital will continue to see and treat children with minor illnesses and minor injuries and who do not need an overnight stay. Children who are seriously ill attend via ambulance or are referred by their GP will no longer come to Alexandra Hospital. They will be seen and assessed by expert paediatric teams at Worcestershire Royal. Many of these will still return home but for those requiring an overnight stay in hospital they will be admitted to the dedicated 35 bed facility at Worcestershire Royal.

Dr Short added: “We have made sure that we have enough beds on our dedicated specialist children’s ward at Worcestershire Royal to ensure to meet the needs of the children of Worcestershire. This means that we have the beds available for any child needing to stay in hospital overnight and transferred under this temporary arrangement. In addition, by all of our clinical teams being available on one site, children will be seen and treated quickly by senior paediatric staff.

"Over the coming weeks we will be working to ensure local people are aware of this temporary change. NHS 111, the ambulance service and GPs will be able to support anyone concerned about a child’s condition, with parents encouraged to take sick children who might need a hospital bed to Worcestershire Royal Hospital. However, should a child be brought into A&E at Alexandra Hospital and need to see a paediatrician they will be taken by ambulance to Worcestershire Royal Hospital.”

“We have known for some time that the paediatric service has been fragile at Alexandra Hospital but we had hoped that the trust could keep it going until the public consultation on the acute services review had taken place. However, this is no longer possible. We have a responsibility to commission safe and secure services and the shortage of staff means it would be unsafe to continue with the current arrangements.

“The trust’s decision to temporarily transfer inpatient paediatric care is therefore understandable and reasonable. Staff have worked tremendously hard over past months to keep both the Children’s wards going at both hospital sites and we would like to thank them for going above and beyond what would normally be expected of them."

ENDS

Notes for Editors

Currently there are over 3,000 attendances every year to the children’s outpatient service at Alexandra Hospital. This service will remain unchanged, and children will continue to be seen as outpatients and have their diagnostic tests in their local hospital.

Planned surgery on children will continue to take place at Kidderminster Treatment Centre and Worcestershire Royal Hospital as now.

Children under two years of age who require surgery will be transferred to Birmingham Children’s Hospital, as now.

All ambulances will take critically ill children straight to the Worcestershire Royal Hospital.

This arrangement will be put in place from September 2016 and remain in place until the outcome of the public consultation into the future of acute hospital services model is known, or until there are sufficient medical and nursing staff to reopen services on two sites.

The Alexandra Hospital will treat children with minor injuries and illnesses as now. GPs will continue to be able to refer children to the Alexandra Hospital for further investigations as now but seriously ill children will be sent to Worcestershire Royal to be assessed. There will also be the option of referring children to be assessed on either the same day or following day in an urgent outpatient clinic (not weekends).

Staff at the Alexandra will have immediate access to telephone and telemedicine support from Consultant Paediatricians based at Worcestershire Royal Hospital.

Any child who presents at the Alexandra Hospital in an unresponsive state will be given immediate treatment by staff trained in advanced paediatric life support before they can be transferred by ambulance to the Worcestershire Royal Hospital or Birmingham Children’s Hospital. Staff trained in advanced paediatric life support will include emergency medicine consultants, emergency department nurses, anaesthetists, intensivists and primary care clinicians. A clinician with advanced paediatric life support training will be on duty 24/7 on the Alexandra Hospital site.

The reason for announcing these temporary changes now to take place in September is to ensure that a comprehensive publicity campaign can take place to ensure that parents, carers and the public are aware of what facilities are available at Alexandra Hospital for children and where very sick children requiring an inpatient bed will be safely treated.

To mitigate this paediatric consultants have been ‘acting down’ and staying at the Alexandra Hospital overnight to provide cover. This has impact on their ability to work during the day when the paediatric department is busier. The consultants have provided this cover as part of their agreed job plans. In addition, consultants are now acting down regularly and at short notice to cover gaps in the middle grade rota at the Worcestershire Royal site, which impacts on their ability to undertake their normal regular duties such as ward rounds and clinics.

On each site there are fewer than 10 consultants on the on call rota, and consultants are not timetabled to be in the hospital at all times of peak activity.

Clarity of what will be available at Alexandra Hospital for children

Although there will be no inpatient paediatric beds at Alexandra Hospital, the following will be available:

UCC staff on duty trained in paediatric life support (i.e. Advanced Paediatric Life Support (APLS) trained nurses and doctors) to manage presentation of a very sick child; plus additional support from the Emergency Department (ED), resident on-call anaesthesia team and critical care outreach.

Access to immediate telephone/telemedicine support from Consultant Paediatricians located at Worcestershire Royal Hospital.